A poor prognostic sign of congenital diaphragmatic hernia (CDH) is

Correct Answer: C

Rationale: In the context of a pediatric nurse exam, understanding the poor prognostic signs of congenital diaphragmatic hernia (CDH) is crucial for providing effective care to infants. Option C, early respiratory distress within 6 hours of life, is the correct answer because it indicates severe respiratory compromise and is associated with a higher mortality rate in infants with CDH. This early onset of respiratory distress is due to the herniation of abdominal contents into the thoracic cavity, leading to lung hypoplasia and pulmonary hypertension. Option A, grunting, and option B, use of accessory muscles, are common signs of respiratory distress in infants but are not specific to CDH. These signs can be seen in various respiratory conditions in neonates and do not specifically indicate CDH. Option D, a scaphoid abdomen, is a physical finding seen in infants with CDH due to the displacement of abdominal contents into the chest, but it is not as specific or as significant of a prognostic indicator as early respiratory distress. Educationally, this question helps reinforce the importance of recognizing early signs of respiratory distress in infants with CDH. Understanding the unique challenges and complications associated with CDH is essential for pediatric nurses to provide timely and appropriate interventions to improve outcomes for these vulnerable patients.

Correct Answer: C

Rationale: The correct answer is C) Achondroplasia. Chromosomal causes of congenital malformations refer to genetic disorders that result from abnormalities in the structure or number of chromosomes. Achondroplasia is caused by a mutation in the FGFR3 gene on chromosome 4, leading to dwarfism and characteristic skeletal abnormalities. This condition is a classic example of a chromosomal cause of congenital malformation. A) Prader-Willi syndrome is a genetic disorder caused by the loss of specific genes on chromosome 15, resulting in intellectual disability, obesity, and other physical and behavioral issues. While it is a genetic disorder, it is not specifically a chromosomal cause of congenital malformations. B) X-linked hydrocephalus is a condition associated with mutations on the X chromosome that lead to an abnormal buildup of cerebrospinal fluid in the brain. While it is a genetic disorder, it is not a chromosomal cause of congenital malformations. D) Treacher Collins syndrome is a genetic disorder caused by mutations in the TCOF1, POLR1C, or POLR1D genes, not by chromosomal abnormalities. It results in craniofacial deformities such as underdeveloped facial bones and structures. While it is a genetic disorder, it is not a chromosomal cause of congenital malformations. Understanding the distinction between chromosomal causes of congenital malformations and other genetic disorders is crucial for healthcare professionals, especially pediatric nurses, as it helps in accurately diagnosing and managing patients with these conditions. Recognizing the specific genetic basis of a disorder can guide treatment decisions and provide valuable information for families regarding recurrence risks and genetic counseling.

Correct Answer: D

Rationale: The correct answer is D) Omphalitis (infection of the umbilical stump) as a common skin and soft tissue manifestation of neonatal bacterial infections. Omphalitis is a serious infection that can occur in newborns due to bacterial contamination of the umbilical stump. It is important for pediatric nurses to be aware of this condition as it can lead to systemic infection if not promptly treated. Facial cellulitis (option A) is more commonly seen in older children and adults, usually due to bacterial skin infections. Scalp abscess (option B) is also more common in older children and is often associated with localized infections or trauma. Fasciitis (option C) is a deep soft tissue infection that is rare in neonates and typically presents differently than a superficial skin infection like omphalitis. Understanding these common skin and soft tissue manifestations of neonatal bacterial infections is crucial for pediatric nurses to provide timely and appropriate care to newborns. Recognizing the signs and symptoms of omphalitis can help prevent serious complications and ensure the well-being of the infant.

Correct Answer: B

Rationale: The correct answer is B) Decrease the risk of cerebral palsy in surviving infants. Administering magnesium sulfate antenatally before preterm delivery has been shown to reduce the risk of cerebral palsy in surviving infants. This is because magnesium sulfate has neuroprotective properties that help in reducing brain injury and neurological deficits in preterm infants. Option A) Reduce rates of necrotizing enterocolitis is incorrect as magnesium sulfate administration is not primarily aimed at reducing necrotizing enterocolitis in preterm infants. Option C) Improve overall survival is not directly related to the administration of magnesium sulfate, as its main benefit lies in reducing the risk of cerebral palsy rather than overall survival. Option D) Decrease respiratory distress syndrome in premature infants is also incorrect, as magnesium sulfate does not have a significant impact on respiratory distress syndrome. In an educational context, it is crucial for pediatric nurses to understand the benefits and implications of antenatal magnesium sulfate administration in preterm deliveries. This knowledge is essential for providing evidence-based care to pregnant women at risk of preterm labor and in improving outcomes for preterm infants, particularly in reducing the risk of cerebral palsy. Understanding the rationale behind using magnesium sulfate can guide nursing practice and contribute to better patient outcomes in neonatal care.

Correct Answer: B

Rationale: In this question, the correct answer is B) depression. Chronic fatigue syndrome (CFS) is commonly associated with depression due to the debilitating nature of the condition, which can lead to feelings of hopelessness, sadness, and lack of interest in activities. Individuals with CFS often experience physical symptoms that can contribute to the development of depression. Option A) anxiety is not typically the primary psychiatric disorder associated with CFS. While individuals with CFS may experience anxiety due to the impact of their condition on their daily lives, depression is more prevalent. Option C) obsessive compulsive disorder (OCD) and option D) social phobia are not commonly associated with CFS. These disorders involve specific patterns of behavior and thought processes that are not typically linked to CFS. In an educational context, understanding the psychiatric comorbidities of CFS is crucial for healthcare professionals, especially pediatric nurses. By recognizing the common association of depression with CFS, nurses can provide holistic care that addresses both the physical and mental health needs of pediatric patients with CFS. This knowledge enables nurses to implement appropriate interventions and support systems to improve the overall well-being of their patients.